Form Pa-41 Schedule B - Dividend And Capital Gains Distributions Income - 2014
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11404710053
PA-41 SCHEDULE B
Dividend and Capital Gains
Distributions Income
2014
OFFICIAL USE ONLY
PA-41B (03–14)
Name as shown on the PA-41
Federal EIN or Decedent’s SSN
START
Caution: If the estate or trust’s total PA-taxable dividend income is equal to the amount reported on the estate or trust’s federal Form
1041 and there are no amounts for Lines 2 through 10 of Schedule B, the estate or trust must report the interest income on Line 2
of the PA-41, Fiduciary Income Tax Return, but the estate or trust does not have to submit Schedule B. If there are any amounts for
any of the Lines 2 through 10 of Schedule B, the estate or trust must complete and submit Schedule B with the estate or trust’s PA-41,
Fiduciary Income Tax Return.
1. $
1. Dividend income reported on federal Form 1041 Line 2.
2. $
2. Dividend income from federal Schedule K-1(s). See instructions.
3. $
3. Tax-exempt dividend income. See instructions.
4. Other reduction adjustments. See instructions.
4. $
Description:
5. $
5. Add the amounts on Lines 2, 3 and 4.
6. $
6. Subtract Line 5 from Line 1.
7. Other addition adjustments. See instructions.
7. $
Description:
8. $
8. Capital gains distributions.
9. $
9. Dividend income from partnership(s), from PA Schedule(s) RK-1 or federal Schedule(s) K-1.
10. Dividend income from PA S corporation(s), from PA Schedule(s) RK-1
10. $
or federal Schedule(s) K-1.
11. Total dividend income
11. $
Add Lines 6, 7, 8, 9 and 10. Enter on Line 2 of the PA-41.
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